Prolapse of lumbar intervertebral disc is caused in most cases by sprain,
fatigue or cold. It often occurs between the cases by sprain, fatigue or cold.
It often occurs between the 4th and the 5th lumbar vertebrae or between the 5th
lumbar vertebra and 1st sacral vertebra, and often in youth and the middle-aged
of 20-40, with the males surpassing the females in number.
Main Points
of Diagnosis
1. Most of the patients have a history of trauma or cold invasion.
2. There arises a sudden lumbago in one side, which radiates to the lower
limb. Cough, sneezing, bowel movement and other actions which exert pressure on
the belly can aggravate the in the lumbus and the leg. The pain is sharp at the
acute stage and at the chronic stage it is sometimes relieved and sometimes serious
with frequent recurrences.
3. The physiological lordosis in the lumbar portion
disappears. There is tenderness beside the corresponding vertebral spinous process,
which can radiate to the lower limb. The raising test of the straight-leg on the
affected side shows positive. The muscles are atrophic. The muscular tension is
reduced. The force of the toe extensor muscle and flexor muscle is decreased.
The reflex of the knee and the Achilles tendon is weakened or has disappeared.
The dermal sensation in the corresponding areas controlled by the sciatic nerve
of the shank is reduced or lost. The dermal sensation in the saddle area and the
function of the sphincter muscles are also weakened or even lost. The movement
of the lumbus is distinctly limited. The extension of the lumbus can increase
the pain, while flexion or lying on the side can relieve it.
4. X-ray film
shows that the corresponding intervertebral space becomes narrow, or narrow in
the anterior part and wide in the anterior part and wide in the posterior part.
There may be labial hyperosteogeny at the margin of the vertebral body.
5.
CT scanning can confirm the diagnosis.
Differentiation and Treatment of Common
Syndromes
1. Replacement by Manipulation
The patient is told to sit on
a stool. An assistant fixes the lower limbs and pelvis of the patient. If the
patient has pain in the lumbus and the leg of the right side and the spinous processes
are inclined toward the right side for example, the operator stands by the right
side, runs his right arm past the patient's right armpit, gets hold of the patient's
neck in his hand and makes the patient's head a bit forwardly-inclined. He presses
with his left thumb the patient's spinous processes which are inclined to the
right. The patient's upper part of the body is to be bent forward to the full
extent, next turned to the right, and then rotated forcefully backward to the
maximum extent. At the same time, the operator presses firmly leftward the inclined
spinous processes with his left thumb. If a sound is heard, the replacement is
indicated. 5-7 days' rest in hard bed is required after the operation.
2.
Replacement by Traction
Pelvic hammock can be used for the traction. The traction
cord runs through the trochlea over the bed head and is tied to the two sides
of the hammock. The traction weight is 10-13 kg for each side. The foot side of
the bed is raised. The traction is done for 1-2 hours a day. If it is combined
with massage therapy, the result will be better.
3. Herbal Therapy according
to Syndromes
1) Early Stage
Main symptoms and Signs: The lumbago comes
suddenly and is very sharp. Prostrating or turning aside is impossible. the illness
involves the lower limb. It manifests itself in pain, numbness or bulging.
Therapeutic
Principle: Promoting blood circulation, removing blood stasis and clearing away
obstruction in the channels to relieve pain.
Recipe: decoction of Four Ingredients
for Relieving Pain.
2) Late Stage
Main Symptoms and Signs: The illness
has had a long duration. The muscles have become atrophic or numb. The lassitude
in the loin and knee. The illness becomes severe after fatigue, intolerable to
long-time standing or walking.
Therapeutic Principle: Tonifying and replenishing
the liver and kidney, strengthening muscles and bones, relaxing muscles and tendons
and activating collaterals.
Recipe: Decoction for Tonifying the Kidney and
Promoting Blood Flow.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan,
Hutian Developing Area,
Huaihua city, Hunan province
China